28 Hours in the Emergency Room

“You have arrived at your destination,” our car’s navigation system announces. Crossing the street, I lean on my partner’s shoulder. An involuntary shudder ripples through me as I succumb to a wave of assaulting nausea followed by a sharp pain in my abdomen. I stare questioningly at the letters “gency” flickering on the neon sign of the hospital building. Two figures emerge from the shadows brushing past us, kicking abandoned litter in their wake. The one wearing the long coat glances at me briefly. Turn back before it’s too late, his eyes seem to say.

At the entrance to the overflowing emergency room, my husband finds a wheelchair and pushes me past two security men and a no-nonsense-looking officer. He secures the only available spot next to a vending machine. 

Across from us, three women wearing identical hospital-issued gowns sit; their shapeless figures seem to ooze from their cramped metal chairs. Several nursing home patients are shuffled off to another corner. To my left is a young man clutching his stomach in a familiar way. He is wearing a black-hooded sweatshirt that partially hides his face. A feeling of despair permeates the room. More than 24 hours would pass before I’d comprehend that we were all the same—we were all invisible to those we needed most.

A slender man with graying thin hair and a matching translucent complexion weaves his way over to us. He introduced himself as Dr. L., the hospital floor manager. Tugging on his ill-fitting lab coat, he asks if I would mind answering some questions. I shrug, recognizing the futility of any medical privacy in this situation.

I give him the briefest synopsis of a complicated history. A seemingly routine appendectomy two years earlier led to unrelenting pain, neurological issues, and an exhaustive search for answers. Finally, I was admitted as a “medical mystery” to this very hospital. After weeks of debilitating tests and no answers, I was to be discharged. Ready to sign off on my release papers, the resident told me, “You just have to accept the fact that you are going to have pain for the rest of your life. You’ll come here to the pain clinic every few weeks.” I refused. I insisted on speaking with a surgeon and signed up for exploratory surgery instead. The surgeon found a trapped omentum (stomach lining) caused by the previous surgeon and repaired it, but in the process, he nicked the fascia (a muscle), which weeks later tore and required yet another surgery at this very place. Now, this familiar pain was back. Earlier that day, I went to my primary care physician, who sent me to the emergency room to seek the surgeon’s help.

“We’ll get you a CT scan right away,” he says. Then he lowers his voice as if in confidence—”Clearly, you have a thorough understanding of your condition. Not like the others.” Should I point out that the others have been waiting much longer than I have? Shamefully, I say nothing. I watch as he makes his way to the inner sanctum of the emergency room, trailing behind an air of despair. I will never see him again.

An Hour Later (10:45 pm)

I feel someone grab the back of my wheelchair, thrusting it forward—a shock of pain races up and down my body. “Watch out!” my husband says, moving in to embrace me. The assailant is a burly 20-something man wearing a faded heavy metal shirt and baggy jeans. He scrapes by in his wheelchair mumbling obscenities. The officer guarding the doorway jumps up from her chair. “For someone in a wheelchair, you have a lot of energy.” She smacks the baton in her hand. “Get over here.” He ignores her and zips around the room. No one seemed to notice except the unfortunate few who were in his way. “Get out of MY emergency room,” the officer bellows, puffing her chest to appear taller than her five-foot-two-inch frame. She’s by his side in seconds and pushes him outside. Although horrified by how crudely he was being treated–he was a patient too who deserved dignified treatment; I can’t help but feel as if everyone in the waiting room exhaled in collective relief.

Dismay (2 am)

“We have no record of your wife,” a clerk tells my husband. “You aren’t in our system…” Therefore, you don’t exist; I finish her sentence in my head. She looks at her computer, then at me, and almost as an afterthought, she says, “We can enter you in now?!” Her voice raised an octave as if hinting these thoughts–Go Home. Now! While you can. I sigh, pausing. I don’t know what to do. Then she asks, “What’s your name?” Mechanically, I answer, feeling the weight of the past four hours waiting— all for nothing.

The tedious registration is completed, and we wait, still hopeful someone will soon come to our aid. A spark of energy pushes me to take a proactive step. I take out my phone and call the answering service for my primary care doctor. Since she sent me to this ER to seek the help of my surgeon, surely she would help?

A monotone voice answers. “It is not our policy to intervene. You are now under hospital care and no longer are our responsibility.”

“But I am NOT getting care,” I protest, hearing my voice rise in frustration. I take a deep breath and speak more evenly. “Please! Couldn’t I speak to the doctor on-call?” 

“The doctor can not help you. You are now under hospital care.” 

“Could I at least leave a message for my doctor?”

“You may call back during normal business hours. Good day.” Click.

Stunned, I held the phone for a few more minutes before placing it in my bag.

You might be asking yourself, why don’t we leave? Have you ever waited in an endless line of people and thought— I should go? But you don’t leave because your mind starts playing tricks on you— as soon as you leave, they will call your name, and then you’ll be sorry. It was like an insidious force was sucking our free will to leave. We’d been taken hostage by pain and exhaustion. Although we could leave, we didn’t.

False Euphoria (6:30 am)

They called my name!!!

You’d think I had just won the lottery. We enter the much-anticipated inner chamber of the emergency room. With blessed pain relief seeping into my body, a bed, a chair, and a curtain to envelop us, I slip into a foggy sleep. Little did I realize that it would be eight more hours before any sign of help would arrive.

Limbo (2:44 pm)

In this strange limbo state (perhaps partially drug-induced), I recall Samuel Beckett’s Waiting for Godot, also known as “Theater of the Absurd’s first theatrical success.” The entire play is about two characters waiting for the arrival of a mysterious Godot, who continually sends word that he will come, but he never does. In my fuzzy brain state, I amuse myself that Godot sounds an awful lot like “God Doctor.” I have a moment of clarity perhaps (or sleep deprivation) that we, too, are in a theater of the absurd (aka hospital’s emergency room), and we are waiting for our Godot, our doctor who likes to think of himself as a kind of god. I recall the famous line from the play and feel momentarily relieved that now I, too, know my purpose.

“Why are we here? That is the question. And we are blessed in this, that we happen to know the answer. Yes, in this immense confusion, one thing alone is clear. We are waiting for Godot to come” (Samuel Beckett, “Waiting for Godot”)

An indeterminate amount of time passes. A flimsy curtain separates me from my neighbor. Although I don’t see him, I can hear his pain-filled cries. An irritable nurse barks questions at him. His anguished reply, “Yes, Ma’am,” leaves a sour taste in my mouth. He’s abandoned to his misery. When a rancid stench permeates the air, he cries out, “Sorry.” 

“Do you need help?” I say and immediately regret my inane offer. 

“Thank you,” he says. “I’m okay.”

It’s a lie we both accept. We know the truth is that we are far from being okay.

It has been 17 hours since we first arrived. We are still waiting. Ten hours ago, I had a CT scan, but we still don’t know the results. As of yet, not a single doctor has come by to examine me.

Meanwhile, care of any sort seems to be a lost commodity. Through our flimsy curtains, we hear a doctor flirting with a nurse. The doctor tells a crude joke. She muffles a girlish laugh.

Paramedics wheel a woman curled up in a fetal position on a gurney. They talk about her as if she is not there. Suddenly she bolts up, screaming as if someone were slicing her open. “Get me some water! “WATER!”

“You don’t talk to me like that,” I hear the nurse say. Then I hear more muffled conversations dismissing this woman who is clearly in pain. “She’s just here seeking opioids,” they say. 

Dismissed (3:00 pm)

A junior surgical resident enters through my curtain sanctum. “Your CT scan is unremarkable. You have a substantial fibroid that could be giving you pain.” Immediately, he turns to leave. He raises a hand to his mouth to cover a yawn. Looking at his watch, he backs toward the curtain. “We don’t see anything else. You can go home now. Follow up with your doctor tomorrow.”

“But, couldn’t it be adhesions? My fibroid is on the right side, but the pain is on the left,” I say, desperate to keep him one minute longer, even though it’s clear he doesn’t want to help.

His answer comes to me from behind the closed curtain. “Adhesions don’t cause pain. I’ll talk it over with the senior resident.”

21 hours and waiting…

Three more hours pass before the resident returns with a senior surgical fellow. Without any preliminaries, the doctor presses on my abdomen. I descend into a swirling pit of pain and nausea. Closing my eyes, I attempt to slow my breathing to stave the next wave of pain.

“We don’t believe adhesions cause pain.” I hear him say.

“But she’s clearly in pain,” my husband says. “We want to talk to Dr. M.”

I hear the latex gloves hit the rim of the wastebasket with a ping. “He’s in surgery. He won’t come.” I don’t open my eyes. I sigh both in relief at his departure and in despair at his words.

Godot is Here! (22 hours waiting, 7:45 pm)

Dr. M. briskly flings my curtain aside. “You can’t come running to me every time you have pain, expecting me to open you up.”

I’m stunned into silence.

He has one foot outside the curtain, ready to flee. Then he seems to reconsider. He takes a few steps closer, leans over, and presses his fingers on my stomach. “No hernia,” he says. “You’ve got a large fibroid. My team will contact gynecology.” 

“But…”

“Let him go. He obviously doesn’t want to help us,” my husband whispers.

I say nothing, but why didn’t I feel relieved that it was ‘just a fibroid?’

More Waiting (10:00 pm)

We are waiting for a member of the gynecology team. I get an ultrasound. We wait for the results, then wait for a doctor… any doctor.

Free at Last? (12:10 am)

A shift change brings in a new emergency room doctor. He seems genuinely surprised that the gynecology team hasn’t come in. “We can’t admit you,” he says almost apologetically, then confides–” at this point, they are unlikely to come. “The GYN team will call to follow up,” he assures. They never do.

The Diagnosis (1:15 am)

“You are free to go,” the nurse says, unhooking my IV and leaving me to get dressed. At this point, I can’t sit up without help. My husband steps in, gently bracing me as I put on my clothes.

A few minutes later, the nurse brings the discharge papers. My official diagnosis: You have been diagnosed with abdominal (belly) pain. “Phew! I’m glad we got that clarified,” I say, suppressing a despondent laugh. My husband catches me as I stumble, taking my first step. “Could we get a wheelchair for my wife?” he calls out.

As my husband wheels me out, I scan the overflowing waiting room—our holding cell for a night. A suffocating feeling of déjà vu seeps in as I recognize the triplet-gowned women, the hooded sweat-shirted youth, and the row of nursing home patients— all there— unmoved and unchanged. They were still waiting, waiting for a Godot who would never come. As we shut the waiting room door behind us, I feel a distinct change in the atmosphere. It takes me a second to decipher what it is— the scent of despair is gone.

Who Is The Wiser? (28 hours. 1:30 am)

My husband eases me onto a bench by the front door of the emergency room and leaves to bring the car. To my left is a middle-aged woman I recognize. She had a CT scan just before I did. We nod in acknowledgment of our shared time together in the waiting room. Both of us hold tightly to the papers releasing us to the outside world.

Just then, a young man stumbles through the front door and promptly squeezes between us on the bench. He sits so close that I can hardly stand the sour mixture of stale alcohol, sweat, and something uncomfortably familiar that emanates from his body. I hold my breath to stifle a gag reflex and move a little closer to the woman.

He swipes a hand absently at the back of his neck as if to rid a pesky fly. Only there is no fly. With a surreptitious glance, I see he is bleeding from a neck wound. He wipes his bloody hands on his torn jeans. 

“You here.. how long?” he asks.

“Long time—28 hours,” I say. “You look hurt!” Immediately I regret the inane obvious statement.

“Les-go,” he slurs. His face twists into a lewd wink. He gestured with his bloody-crusted hand. “We get some drink? 7/11…get alcohol. Come. All good,” he says.

Instantly, an imposing woman in a blue uniform ambles over. She stands with her hands on her hips and looks right at him. “If you want a doctor, go into the waiting room. Tell me your name?”

She stares down at him. He doesn’t answer. He doesn’t make eye contact. “What’s your name?” she repeats. She takes a step forward. One eyebrow is raised. “Your date of birth?”

“85,” he mumbles.

She shifts her feet in place. “The date. Give me a date!” Her voice bellows. 

A moment passes, then he slurs something that sounds like—”1836″

“You think that’s funny? That’s no date. YOU. Come with me!” She turns her back and heads to a darkened office across from us, clearly expecting him to follow. 

He glances at her briefly with his bloodshot eyes, gets up, flips her off, and staggers out to the street. Who is the wiser? I’m humbled. He still has enough wits about him to leave this place. It took me 28 hours to come to the same conclusion.

Gingerly, I step outside into the cold night air. I don’t flip anyone off (though I secretly want to). At that moment, I am flooded with relief and gratitude. We get to drive away from this nightmare, no better off than when we came in, but still free at last. Leaning back into the passenger seat, I closed my eyes. I recall the last line of the play, Waiting for Godot– “tomorrow, when I wake, or think I do, what shall I say of today?”

Avi Zahavi

July 2023